Conceptual model for capacity development of Bulgarian healthcare

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Introduction

The Bulgarian society and the economy in our country have to achieve some tasks in order to accomplish successful development of the healthcare system. Comparing to the other European countries Bulgarian healthcare is quite behind the level it should be. The prognosis about its development should take into account the level of the economic development and the construction of the capacity of Bulgarian healthcare. This model, relevant to the environment, shows the development of the healthcare system until year 2030.

Capacity building of Bulgarian healthcare is defined as a systematic approach for continuous learning how to improve its potential, how to be used in the most effective way its labor, material and financial resources in order to achieve its main objectives.

Objective

The objective of this study is to develop a prognostic conceptual model for capacity development of Bulgarian healthcare by year 2030 based on а comparative analysis, a conducted survey among healthcare managers and an expert appraisal.

Methods

Comparative analysis.

Critical analysis.

Sociological method – a survey conducted among healthcare managers.

Statistical methods.

Development of a prognostic conceptual model for capacity development of Bulgarian healthcare by year 2030 using a modified methodology by Gladilov St. (2002). [2]

Results

The expenditure per capita is an important element in building the capacity of healthcare. In 2006 public expenditure for healthcare per capita in Bulgaria amounted to 245 Levs. [3, p. 20]

In 2008 the public expenditure per capita is 372 Levs and in 2013 it is respectively 463 Levs. (Table 1)

So for 7 years there is an almost double increase in the public expenditure per capita for healthcare in Bulgaria.

Table 1.

Public expenditure for healthcare per capita in Bulgaria [5]

Years

2008

2009

2010

2011

2012

2013

Total expenditure for healthcare

(thousands levs)

2 831

3 117,3

3 000,8

3 247,6

3 303,2

3 540,3

Population

7 606 551

7 563 710

7 504 868

7 282 041

7 327 224

7 240 000

Public expenditure per capita (levs)

372

413

399

444

454

463

One of the questions from the survey among healthcare managers was “How many levs will reach these public expenditures per capita in 5 years?” 242 managers have answered to this question and they indicated the mean average 972.89 levs. (Std. Dev. = 72.689; Mean=972.89; N=242) [3, p. 20]

We assume that this amount is achievable for the specified period. To reach it an annual step increase is required equal to 1/5 of the difference between the proposed expenditure per capita in 2018 and those in 2013. (Table 2)

972.89 – 463 = 509.89 levs

509.89 ∕ 5 = 101.978 levs

Table 2.

Prognostic public expenditure for healthcare per capita in Bulgaria (in Levs)

Year

2013

2014

2015

2016

2017

2018

2019

2020

2030

Public expenditure per capita for healthcare (Levs)

463

564.98

666.96

768.94

870.91

972.89

1074.87

1176.85

2196.63

These inputs are taken into account in working out a prognostic model for capacity development of the Bulgarian healthcare for the period 2030.

The prognosis shows that in 2020 the public expenditure for healthcare per capita would be 1176.85 levs and in 2030 respectively – 2196.63 levs.

Picture 1. Public health expenditure as a share of GDP [1, p. 18]

Public health expenditure as a share of GDP is about 4 percent for the last 13 years, with an average of 7 percent for EU countries. (Picture 1)

The model foresees a gradual increase in the share of public spending on healthcare from the state budget and from the NHIF about 0.1 to 0.2% per annum.

The final result of this financial model is to reach the proportion of healthcare expenditures in the optimal scenario for year 2020 — 4.6% and for 2030 — 5.6%. If this happens to be achieved about this indicator Bulgaria is getting a step closer to some EU countries.

Conclusion

Тhe specifics of the process of capacity building of Bulgarian healthcare is expressed in the chronic insufficient financing of the system. The health spendings per capita are several times lower than the lowest in the EU countries.

The above results show that even in year 2020 and in 2030 Bulgarian healthcare will work in conditions of insufficient funding.

However, the analysis of the data obtained from the above prognostic model shows the need for efficient use of the available resources, as well as a need for a change of the model for financing towards its liberalization.

The optimal capacity building of the Bulgarian healthcare until year 2030 should be carried out practically through an effective management carried out by competent health managers, as well as the implementation of effective prevention programs financed by the Ministry of Health.

Sandier, S., Paris, and D. Polton., «Health Care Systems in Transition: France. Copenhagen, Denmark: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies», 2004. http://www.euro.who.int./document/e83126.pdf

World Health Organization: Global database for expenditures in health care.

Conceptual model for capacity development of Bulgarian healthcare

The purpose of this article is to develop a prognostic conceptual model for capacity development of Bulgarian healthcare by year 2030 based on а comparative analysis, a conducted survey among healthcare managers and an expert appraisal. The expenditure per capita is an important element in building the capacity of healthcare. In 2006 public expenditure for healthcare per capita in Bulgaria amounted to 245 Levs. In 2013 the public expenditure per capita is respectively 463 Levs or there is an almost double increase.